Vascular最新文献

{"title":"Challenges in normalizing pulse wave velocity scores: Implications for assessing central artery stiffness.","authors":"Alessandro Gentilin","doi":"10.1177/17085381231194145","DOIUrl":"10.1177/17085381231194145","url":null,"abstract":"","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1410-1411"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9959874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of high quality team medicine on outcomes of chronic limb-threatening ischemia patients with infrapopliteal bypass.","authors":"Taira Kobayashi, Masaki Hamamoto, Takanobu Okazaki, Ryo Okusako, Misa Hasegawa, Kazufumi Ishida, Tomoaki Honma, Masamichi Ozawa, Shinya Takahashi","doi":"10.1177/17085381231194959","DOIUrl":"10.1177/17085381231194959","url":null,"abstract":"<p><strong>Objectives: </strong>A team approach for treatment of patients with CLTI is used worldwide. However, the quality of team medicine is a concern. The Global Vascular Guidelines provide recommendations for high quality team medicine, but there is limited knowledge of the significance of team quality in CLTI treatment. The objective of this study is to evaluate the effects of team quality on clinical outcomes after infrapopliteal bypass.</p><p><strong>Methods: </strong>A retrospective analysis was performed in 337 patients who underwent 414 infrapopliteal bypasses under a team medicine approach at a single center between 2009 and 2021. In 2017, team medicine was reorganized for improvement of quality. Comparisons were made between before (Group 1; 160 patients, 195 limbs) and after (Group 2; 177 patients, 219 limbs) reorganization. The primary endpoints were limb salvage and wound healing after infrapopliteal bypass.</p><p><strong>Results: </strong>The patients included 227 males (67%) and had a median age of 76 [68-83] years. Diabetes mellitus was present in 67% and end-stage renal disease with hemodialysis in 37%. The follow-up rate was 96% in a mean follow-up period of 31±30 months. The 3-year limb salvage rate was significantly lower in Group 1 (before reorganization) than in Group 2 (after reorganization) (84% vs 95%, <i>p</i> = .001). The wound healing rates in the whole cohort were 72% at 6 months and 85% at 12 months, with no significant differences between the groups. In multivariate analysis, the risk factors for major amputation were treatment before reorganization (HR 2.68; <i>p</i> = .017), hemodialysis (HR 2.27; <i>p</i> = .017), and non-ambulatory status (HR 2.63; <i>p</i> = .005).</p><p><strong>Conclusions: </strong>A reorganized team approach with the goal of higher quality was independently associated with reduced major amputation for patients with CLTI treated with infrapopliteal bypass. This result indicates the importance of a high quality team approach for success of this treatment.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1202-1211"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9954638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cilostazol on prevention of late failure of autologous vein grafts.","authors":"Shinsuke Mii, Atsushi Guntani, Sosei Kuma, Masaru Ishida, Sho Yamashita, Kiyoshi Tanaka, Jin Okazaki","doi":"10.1177/17085381231192730","DOIUrl":"10.1177/17085381231192730","url":null,"abstract":"<p><strong>Objectives: </strong>The effectiveness of postoperative medication for the prevention of late graft failure is controversial. We conducted the present study to investigate whether cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass for chronic limb-threatening ischemia (CLTI).</p><p><strong>Methods: </strong>From April 1994 to March 2022, we performed 590 de novo infrainguinal bypass procedures using autologous vein grafts (AVGs) in three hospitals. The bypass grafts were classified according to the postoperative prescription of cilostazol. The loss of graft patency and major adverse limb events (MALEs) were set as endpoints. Patients who died within 30 days and grafts that lost primary patency within 30 days after surgery were excluded. Data up to 3 years were analyzed. The cumulative primary patency (PP), assisted primary patency (AP), secondary patency (SP), and freedom from MALE (ffMALE) rates were calculated by the Kaplan-Meier method and compared between the cilostazol group and the non-cilostazol group. After a propensity score matching, same statistical analyses were performed. In addition, a Cox proportional hazards regression analysis that included preoperative factors, intraoperative factors, and postoperative medications was performed to identify whether cilostazol is an independent predictor for the outcomes.</p><p><strong>Results: </strong>A total of 523 AVGs met inclusion criteria. Kaplan-Meier curves showed that the cilostazol group was superior to the non-cilostazol group in all outcomes, while the cilostazol group was superior to the non-cilostazol group in AP and SP after a propensity score matching. A multivariable analysis showed that non-use of cilostazol was identified as an independent predictor for loss of AP, SP, and ffMALE.</p><p><strong>Conclusions: </strong>Cilostazol improved the mid-term outcomes after infrainguinal autologous vein bypass.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1232-1239"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9949122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde tibial access for revascularization of chronic total occlusions in patients with chronic limb-threatening ischemia.","authors":"Daniel Raskin, Yiftach Barash, Daniel Silverberg, Moshe Halak, Hatem Hater, Boris Khaitovich","doi":"10.1177/17085381231192691","DOIUrl":"10.1177/17085381231192691","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate tibial single access in treatment of chronic total occlusions (CTO) in patients with ipsilateral chronic-limb ischemia (CLTI).</p><p><strong>Materials and methods: </strong>In this retrospective study, data was collected on patients treated for ipsilateral CTO via a tibial artery access between March 2017 and March 2021. Fifty-nine limbs in 57 patients, (42 men, average age 73 years; range 47-96) were treated. Patient's symptoms were classified in accordance with the Rutherford category. The end points were freedom from major amputation and the need for reintervention up to 1 year of follow up.</p><p><strong>Results: </strong>Out of the 59 treated limbs, technical success was achieved in 57 (97%). The treated multilevel segments involved 5 common and 12 external iliac arteries, 23 common and 37 superficial femoral arteries, 23 femoropopliteal segments, 14 popliteal arteries, and 4 bypasses. Mean length of occlusion was 186 mm (range 7-670). Rutherford classification of the treated limbs was category 5 and 6 in 45 patients and category 4 in 14 patients. Three procedural complications occurred and were successfully treated during the same procedure. No immediate post-procedural complication was encountered. Median follow-up was 13 months (range 1-45.3). Reintervention was required in 9 limbs, after an average of 6 months. One year free from amputation rate was 91.2%.</p><p><strong>Conclusions: </strong>Single access via the ipsilateral tibial artery can be a useful, effective, and safe approach for treating CTO in CLTI patients.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1220-1225"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10331809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series of image-guided percutaneous drainage of abdominal aortic graft infection as bridge therapy.","authors":"Helena Baffoe-Bonnie, Khaled I Alnahhal, Kristin Englund, Mark E Baker, Lee Kirksey","doi":"10.1177/17085381231214318","DOIUrl":"10.1177/17085381231214318","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic graft infection (AGI) is a rare complication following endovascular aneurysm repair and is associated with substantial morbidity and mortality. The traditional management of AGI is intravenous antibiotic therapy and surgical explantation. In this case series, percutaneous drainage was used as a bridge therapy in the treatment of AGI.</p><p><strong>Methods: </strong>We report two cases, 78-year-old male and 57-year-old female, in whom image-guided percutaneous drainage was used to treat AGI in two contrasting contexts. Informed consent was obtained from both cases/relatives for publication.</p><p><strong>Results: </strong>Both cases underwent successful percutaneous drainage of AGI utilized as a bridge therapy before definitive surgical reconstruction and graft explantation. Each patient had a different outcome. In the first case, the patient's comorbidities and severe disease state could not be overcome, resulting in his death. The second patient benefitted from the percutaneous drainage by allowing her more time ameliorate her malnutrition before definitive surgery.</p><p><strong>Conclusion: </strong>Data on the outcomes of percutaneous drainage of AGI is limited. The successful procedure described in this case series emphasizes the need to conduct more research to evaluate the safety and efficacy of this treatment approach before the surgical explantation.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1309-1313"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting lower extremity venous insufficiency recurrence following radiofrequency ablation.","authors":"Hakki Kursat Cetin, Eyup Murat Kanber","doi":"10.1177/17085381231193512","DOIUrl":"10.1177/17085381231193512","url":null,"abstract":"<p><strong>Objective: </strong>To clarify possible factors for recurrence of venous insufficiency following radiofrequency ablation (RFA) for the treatment of lower extremity chronic venous insufficiency (CVI).</p><p><strong>Methods: </strong>Patients with lower extremity CVI who underwent RFA therapy were reviewed for inclusion in the study. Patients' characteristics, operative parameters and follow-up outcomes were recorded. Patients were divided into two groups (patients with successful RFA and patients with recurrent venous insufficiency). Groups were compared according to patient demographic features, treated vein characteristics, operative data and follow-up duration.</p><p><strong>Results: </strong>In total, 313 patients matched the study inclusion criteria and 48 patients encountered RFA failure during follow-up. Mean BMI and ratio of COPD were significantly higher in patients with RFA failure (<i>p</i> = .002 and <i>p</i> = .007). The CEAP classification was significantly different between the groups (<i>p</i> = .007). Mean follow-up time was significantly longer in patients with RFA failure (<i>p</i> = .011). Presence of COPD and BMI ≥30 kg/m² increased RFA failure 4.187 times and 2.255 times, respectively (<i>p</i> = .002 and <i>p</i> = .022). Additionally, CEAP C4 significantly increased RFA failure (<i>p</i> = .001). Lastly, longer follow-up time was a predictive factor for RF failure (<i>p</i> = .024).</p><p><strong>Conclusion: </strong>Our study findings demonstrated for the first time that obesity, presence of COPD, presence of veins classified as CEAP C4 before RFA, and follow-up period longer than 48 months were predictive factors for venous insufficiency recurrence following RFA.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1335-1339"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of stent compression in patients with non-thrombotic iliac vein lesions on iliac vein blood flow and related symptoms.","authors":"Minyong Peng, Chao Li, Jiangwei Chen, Chengli Nie, Wen Huang","doi":"10.1177/17085381231194932","DOIUrl":"10.1177/17085381231194932","url":null,"abstract":"<p><strong>Objectives: </strong>To study outcomes in patients with non-thrombotic iliac vein lesions (NIVLs) treated by stents.</p><p><strong>Methods: </strong>We performed a retrospective study that collected 109 patients from January 2016 to August 2020 diagnosed with symptomatic NIVLs. The patients underwent endovenous stenting using the Wallstents. Clinical severity was assessed using the venous clinical severity score and the Villalta scores. The patency was assessed using duplex ultrasound, while the diameters and the blood flow velocities (BFVs) in the proximal, middle, and distal stented segments were recorded simultaneously.</p><p><strong>Results: </strong>A total of 128 stents were placed in 115 limbs (median age, 61 years), with a mean follow-up of 32 months. At 36 months, the Villalta scores went from 12.17 to 3.64 (<i>p</i> < .001). The VCSS went from 9.41 to 3.31 (<i>p</i> < .001). The mean diameters in the proximal, middle, and distal stented segments were 8.52 ± 2.15 mm, 10.13 ± 1.75 mm, and 10.17 ± 1.69 mm in the first month, while the mean BFVs were 31.17 ± 13.66 cm/s, 31.07 ± 11.90 cm/s, and 36.39 ± 18.41 cm/s, respectively. Repeated-measures analysis in 55 consecutive patients from 1 month to 3 years after procedure revealed a decrease of the stent diameter in the proximal stented segment (<i>p</i> = .004); a stabilization of the stent diameter in the middle (<i>p</i> = .43) or distal (<i>p</i> = .45) stented segment; a steadiness of the BFVs in the proximal (<i>p</i> = .40), middle (<i>p</i> = .93), and distal (<i>p</i> = .25) stented segments; and an improvement in the VCSS (<i>p</i> = .03) and Villalta scores (<i>p</i> = .006).</p><p><strong>Conclusions: </strong>BFVs in stented segments remained steady and the symptoms in lower extremities improved after surgery, while stent compression was observed in the diameter of the proximal stented segment, with no impact on BFVs or symptoms.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1352-1363"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-year experience with use of cryopreserved allografts for redo infrapopliteal bypass.","authors":"Davide Mastrorilli, Luca Mezzetto, Gabriele Piffaretti, Mario D'Oria, Salvatore Bruno, Marco Franchin, Gian F Veraldi","doi":"10.1177/17085381231192687","DOIUrl":"10.1177/17085381231192687","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to report the early and late outcomes of cryopreserved saphenous vein (CSV) in redo infrainguinal bypass and to investigate possible predictors of primary patency loss.</p><p><strong>Methods: </strong>All patients who underwent a redo bypass for critical limb ischemia from January 2010 to December 2020 were reviewed. Early and late complications were analyzed and included. The endpoints of the study were all cause mortality, major limb amputation, and primary patency (PP).</p><p><strong>Results: </strong>Data were collected from 95 patients. Among the entire cohort, 16 (16.8%) patients received a cryopreserved vessel bypass with anastomosis in the popliteal artery and 79 (83.2%) patients had cryopreserved vessel bypasses with distal anastomosis in tibial vessels. Median duration of follow-up was 73 months; during this, period estimated survival at 5 years was 80.5 ± 4% (95% CI, 78.0-91.2) and estimates of freedom from limb amputation was 90.3 ± 3.2% (95% CI, 87.3-98.1). Overall, the estimated primary patency of the bypass was 43.7 ± 6.7% (95% CI, 30.2-51.4). On multivariable analysis, intraprocedural tibial vessel angioplasty (HR = 2.3, <i>p</i> = 0.01), distal anastomosis in tibial vessels (HR = 3.6, <i>p</i> = 0.36), and the use of a composite graft (HR = 2.4, <i>p</i> = 0.01) were independently associated with loss of PP.</p><p><strong>Conclusions: </strong>The use of CSV in redo bypass is an effective strategy in salvaging threatened lower extremities and in preventing or delaying limb amputation. Our results confirm that further attempts at revascularization are generally appropriate, even in technically changing patients.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1250-1258"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid artery dissections from transcarotid artery revascularization as reported by the Food and Drug Administration.","authors":"Dongjin Suh, Yuchi Ma, Daniel H Newton, Michael F Amendola, Kedar S Lavingia","doi":"10.1177/17085381231194410","DOIUrl":"10.1177/17085381231194410","url":null,"abstract":"<p><strong>Objectives: </strong>Transcarotid artery revascularization (TCAR) is a hybrid procedure that allows reversal of blood flow away from the brain while placing a stent through direct surgical access of the common carotid artery. It has been shown to have a lower risk of perioperative stroke compared with any prospective trial of transfemoral carotid artery stenting. However, intraoperative injuries related to the procedure and its management are not well characterized. One of the intraoperative complications seen in TCAR is iatrogenic carotid artery dissection (CD). We aim to add qualitative insight in further characterizing CDs and its management in this emerging technology.</p><p><strong>Methods: </strong>The Food and Drug Administration (FDA) maintains the Manufacturer and User Facility Device Experience (MAUDE) database for surveillance of all medical devices approved for use. This database was queried for all cases associated with Silk Road Medical's ENROUTE Transcarotid Neuroprotection System from September 2016 to October 2020. Case narratives related to CD were individually analyzed to determine time of injury (intraoperative, recovery, and post-discharge follow-up). CD reporting was further analyzed for the associated procedural event at the time of injury, number of access attempts to CD repair, and type of CD repair. Reports associated with CD repair were further categorized into endovascular repair and open surgical repair.</p><p><strong>Results: </strong>Of the 115 unique adverse events in the database, there were 58 CDs. Most were identified intraoperatively (<i>n</i> = 55), while three were incidentally found postoperatively. Overall, sheath placement was the most common procedural event attributed to CD (<i>N</i> = 34). There was adequate narrative information about CD repair in 54 patients. Intraoperative repair was performed in 52 cases and two were repaired after post-discharge follow-up imaging was performed.Among CDs that did not require additional access to engage the true lumen, the proportion of endovascular repair (62.5%) was significantly higher (<i>p</i> = .044) compared to the proportion of open surgical repair (37.5%). However, the proportion of open surgical repair (75%) was significantly higher than the proportion of endovascular repair (25%) in CDs with persistent failure to engage the true lumen despite ≥2 access attempts (<i>p</i> = .039).</p><p><strong>Conclusion: </strong>CD is the most common injury related to TCAR as reported on MAUDE. The most commonly reported procedural event associated with CD was sheath placement. The rate of intraoperative endovascular and open surgical CD repair was associated with whether the access to the true lumen of the carotid artery required additional access attempts or not. This should add qualitative insight among the vascular surgery community regarding intraoperative management of CDs from a TCAR procedure.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1291-1294"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9959884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthetic management for lower extremity vascular bypass procedures: The impact of general or regional anesthesia on clinical outcomes.","authors":"André P Schmidt, Marine M Del Maschi, Cristiano F Andrade","doi":"10.1177/17085381231193492","DOIUrl":"10.1177/17085381231193492","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative complications after major surgery, especially vascular procedures, are associated with a significant increase in costs and mortality. Previous studies evaluating general anesthesia versus regional or neuraxial anesthesia for infrainguinal bypass have produced conflicting results. The main aim of the present study is to review current evidence on the application of regional or general anesthesia in patients undergoing infrainguinal bypass surgery and its potential favorable effects on postoperative outcomes.</p><p><strong>Contents: </strong>Patients undergoing vascular surgery often have multiple comorbidities, and it is important to outline both benefits and risks of regional anesthesia techniques. Neuraxial anesthesia in vascular surgery allows overall avoidance of general anesthesia and does provide short-term benefits beyond analgesia. Previous observational studies suggest that neuraxial anesthesia for lower limb revascularization may reduce morbidity and length of stay. However, evidence of long-term benefits is lacking in most procedures and further work is still warranted.</p><p><strong>Conclusions: </strong>Neuraxial anesthesia is usually an effective anesthesia technique for infrainguinal bypass surgery. Elderly patients and those with underlying respiratory problems may display some benefit from neuraxial anesthesia. Further evaluation within institutions should be performed to identify which patients would most benefit from regional techniques. Notably, systemic antithrombotic and anticoagulation therapy is common among this population and may affect anesthetic choices.</p>","PeriodicalId":23549,"journal":{"name":"Vascular","volume":" ","pages":"1191-1201"},"PeriodicalIF":1.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10296184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}